16 July 2010

I love nurses. Specifically, I live our triage nurses. At our facility, they only let the best nurses, with the most experience and the best bullshit meter (and best ability to spot the one "sick" patient amidst the worried well) to work at triage. It's a little bit of a controversial policy, since the better nurses don't all like to work triage, and some of them feel punished having to work out there more often. But it works well, operationally.

We have a computerized patient tracking system which incorporates all the nursing notes, including triage. The patient's chief complaint is chosen from a preformatted list, and if the complaint just doesn't fit any of the options, our triage nurses default to "PAIN - MULTIPLE" and explain in the narrative portion of the triage note. Sometimes they have a little fun with the story-telling, in an understated, "you need to read between the lines" sort of way. Because it's the medical record, you can't write anything that will get you in trouble. But they still want to say "Holy Shit!" at some of the things that come through triage.

Picking up a patient described as "PAIN - MULTIPLE" is something like unwrapping a present from a schizophrenic gift-giver. It could be something as simple as a MVA on a backboard or it could as easily be an anxious patient with multiple somatic complaints. So it is always with a sense of curiosity and utter dread that I open up the triage note to see whether I have unwrapped a nice little gift or a proverbial lump of coal.

So today, I saw my obligatory "PAIN - MULTIPLE" patient, and with a mixture of horror and delight read the following narrative (which I swear is reproduced verbatim, in its entirety):

Shadowfax

About me: I am an ER physician and administrator living in the Pacific Northwest. I live with my wife and four kids. Various other interests include Shorin-ryu karate, general aviation, Irish music, Apple computers, and progressive politics. My kids do their best to ensure that I have little time to pursue these hobbies.

Disclaimer

This blog is for general discussion, education, entertainment and amusement. Nothing written here constitutes medical advice nor are any hypothetical cases discussed intended to be construed as medical advice. Please do not contact me with specific medical questions or concerns. All clinical cases on this blog are presented for educational or general interest purposes and every attempt has been made to ensure that patient confidentiality and HIPAA are respected. All cases are fictionalized, either in part or in whole, depending on how much I needed to embellish to make it a good story to protect patient privacy.

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